Unit 1 part 5 middle adult-older adult

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BrigittaLis
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Unit 1 part 5 middle adult-older adult
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2011-04-14 02:29:04
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ati fundamentals
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ati fundamentals
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  1. Erikson development/stage in middle adulthood
    • Development: psychosocial
    • Stage: Generativity vs. self-absorption
  2. Freud Development/stage in middle adulthood
    • Development: psychosocial
    • Stage: Genital
  3. Piaget Development/stage in middle adulthood
    • Development: Cognitive
    • Stage: Formal Operations
  4. The middle adult often has to balance his personal andprofessionl life with providing assistance to:
    • Aging parents
    • Adult children
    • Grandchildren
  5. Middle dults experience decreases in.... (everything, but ready through it and try not to get too depressed...)
    • Skin turgor
    • Melanin in hair (graying)
    • Hair
    • Near vision
    • Auditory acuity
    • Sense of taste
    • Skeletal muscle mass
    • Range of motion
    • Height
    • Calcium/bone density
    • Blood vessel elasticity
    • Respiratory vital capacity
    • Large intestine muscle tone
    • Gastric secretions
    • Estrogen/testosterone
    • Glucose tolerance
  6. Cognitive development in middle adulthood
    • Raction time/speed of performance slows slightly
    • memory is intact
    • Crystallized intelligence remains (stored knowledge)
    • Fluid intelligence (how one learns and processes) declines slightly
    • Creativity decflines slightly
  7. Psychosocial Development in middle adulthood
    • The middle adult may strive for generativity
    • Uses life as an opportunity for creativity and productivity
    • Has concern for others
    • Parenting considered an important task
    • Strives to do well in one's own environment
  8. Moral development in middle adulthood
    • Religious maturity
    • Spiritual beliefs and religion may take on added importance
    • The middle adult may become more secure in his/her convictions
    • The middle adult often ahs advanced moral development
  9. Self-concept development
    • Women may experience issues r/t menopause, empty nest, and sexuality. Men experience issues related to job performance and ability to provide. Middle adults may also experience:
    • Depression
    • Irritability
    • Difficulty with sexual identity
    • Issues r/t job performance and ability to provide
    • Marital changes with the death of a spouse or divorce
  10. Body-image changes in middle adulthood
    • women: symptoms of menoause, may represent a loss of the reproductive role or femininity, new interest in intimacy
    • Men: decreasing strength may be rustrating or frightening
    • Decreased sex drive may occur as a result of declingig hormones, chronic diseases, or medications
    • Changes in physical appearance may raise concerns about desirability
  11. In regards to nutrition, most middle adults need to:
    • Reduce calories
    • Reduce fats and protein
    • Increase calcium
    • Increase fiber
  12. The middle adult is esp at risk for alterations in health from:
    • Obesity and type 2 diabetes
    • Cardiovascular disease
    • Cancer
    • Substance abuse (alcoholism)
    • Psychosocial stressors
  13. Health screenings recommended for middle adults include:
    • Cardiovascular - bp, cholesterol, lipid levels, and bg levels
    • Nutrition: height and weight
    • Cancers: pap smears, mammograms, BSE
  14. Health screenings for middle adults after age 50 include:
    • Stool for occult blood and/or sigmoidoscopy
    • Prostate-spcific antigen (PSA) and rectal exam
    • Osteoporosis - bone density
  15. Immunization recommendations for healthy middle adults 40-60 yrs include
    • Td (just tetanus and diptheria) every ten years, substituting with one dose of Tdap
    • One dose of MMR or 2 doses if college student, health care worker, r planning international travel
    • 2 doses or varicella if no evidenc of immunity (up to age 50)
    • Starting at age 50, one dose annually of influenza vaccine
  16. Mental health screenings for middle adult can include:
    • Depression
    • Stress
  17. Nutrition counseling for the middle adult includes:
    • Increasing the consumption of whole grains
    • Increasing the consumption of fresh fruits and veggies
    • Limiting fat and cholesterol
    • Increasing Vit. D and calcium supplementation
  18. Injury prevention for the middle adult includes:
    • Avoiding drugs that can lead to subsance abuse
    • Avoiding taking drugs while drivin a vehicle
    • Wearing a seat belt when operating a vehicle
    • Wearing helmets while bike riding
    • Installing smoking and carbon monoxide detectors in the home
    • Securing firearms in a safe location
  19. When performing a psychosocial assessment, a nurse would expect a healthy middle adult to
    A. develop an acceptance of diminshed strength an dincreased dependence on others
    B. Accept one's life as creative and productive
    C. Find someone to share one's life with
    D. Feel frustrated that time is too short for attempting to start another life
    B. Accept one's life as creativ and productive
    (this multiple choice question has been scrambled)
  20. Which of the following physical changes increases during the middle adult years?
    A. muscle tone
    B. Hearing ability
    C. Blood pressure
    D. Cardiac efficiency
    C. Blood pressure
    (this multiple choice question has been scrambled)
  21. Erikson Devlopment/Stage older adulthood
    • development: psychosocial
    • Stage: Integrity vs. Despair
  22. Freud Development/stage older adulthood
    • development: psychosocial
    • stage: genital
  23. Piaget development/stage older adulthood
    • development: cognitive
    • stage: formal operations
  24. physical changes r/t the older adult
    • A decrease in skin turgot and subQ fat which leads to wrinkles and dry skin
    • Thinning hair
    • A decrease in chest wall movement, vital capacity, and an incrase in cilia which increases the risk for respiratory infections
    • Slowe reaction time
    • A decrease in smell and taste sensations
    • A decline in near vision (presbyopia)
    • The decreased ability for th eyes to adjust from lght to dark can lead to night blindness while driving
    • An inability to hear high-pitched sounds (presbycusis)
    • A decrease in muscle strength and tone
    • Decrease in digestive enzymes
    • Decrease in intestinal motility, which can lad to an increased risk of constipation
    • An increase in dental problems
    • Decalcification of bones
    • Degeneration of joints
    • Decrease in bladder capacity
    • Prostate hypertrophy in men
    • A decline in estrogen/testosterone production
    • A decline in thyroid hormone an dinsulin production
    • Atrophy of breast tissue in women
  25. True or false: many older adults maintian their cognitive function
    true
  26. What causes common cognitive disorders in older adults?
    • Slowed neurotransmission
    • Impaired vascular circulation
    • disease states
    • poor nutrition
    • structural brain changes
  27. Delirium
    • Acute and temporary
    • Usually the symptom of other physiologic problems
    • Often the first symptom of infection in the older adult
  28. Dementia
    Chronic, progressive, and possibly with an unknown cause (alzheimer's)
  29. Depression
    Chronic, acute, or gradual onset (present for at least 6 weeks)
  30. Developmental tasks of an older adult include
    • Adjustment to lifestyle changes r/t retirement
    • Adaptation to changes in family struture (may be role reversal in later yrs)
    • Dealing w/ multiple losses (ex: death of spouse, friends, siblings)
    • Finding ways not to become socially isolated and overcoming loneliness
    • Facing death
  31. Older adults face difficulties in the are of self-concept which include:
    • Seeing oneslef as an ging person
    • Finding ways to maintain a quality of life
    • Becoming more dependent on others for activities of daily living
  32. Body image changes in older adulthood
    • Adjustments to decreases in physical strength and endurance may be difficult, esp for older adults who are cognitively active and engaged
    • Many older adults may feel frustrated that their bodies are limiting what they desire to do
  33. Factors that influence nutrition in the older adult include:
    • Difficulty getting to and from the supermarket to shop for food
    • Depression or dementia
    • Not wanting to eat alone
    • Meds that impact taste/appetite
    • Prescribed diets taht ususally do not taste good
    • Incontinence that mya cause the person to limit fluid intake
  34. True or false: caloric intake should decrease for older adults
    True, b/c metabolism and muscle mass decreases with age
  35. nutritional recommendations for the older adult include:
    • Increasing the intake of vits D, K, and calcium
    • Increasing fluid intake to minimize the risk of dehydration
    • Taking a low-dosemultivitamin along with mineral supplementation
    • Lmiting salt intake
  36. Cardiovascular risks that can affect the older adult include:
    • CAD
    • HTN
    • stroke
  37. Factors affecting mobility of the older adult include
    • arthritis
    • osteoporosis
    • falls
  38. Mental health disorders that can affec the older adult include:
    • Depression
    • Dementia
    • Suicide
  39. Other disorders that can affect the older adult include:
    • Diabetes
    • Cancers
    • INcontinence
    • Abuse and neglect
    • Cataracts
    • Alcoholism
    • Pain
  40. Heatlh scrennings recommended for the older adult include:
    • CDV (bp, cholesterol, lipid levels, and bg levels)
    • Nutrition (height and weight)
    • Vision exams
    • Hearing exams
    • Cancers (pap smears, mammograms, SBE)
  41. Health screenings recommended for the older adult after age 60 include
    • Stool for occult blood or sigmoidoscopy
    • Prostate-specific antigen and rectal eam
    • Osteoporosis (bone density)
  42. Immunizations for older adults
    Tetanus and diptheria (Td) every 10years substituing with 1 dose of Tdap, one dose annually of influenza vaccinea, and starting at age 65, one dose of PVC
  43. Exercise for the older adult
    In addition to preserving respiratory and vardiovascular functioning, weight-bearing exercises are needed to increase bone density in the older adult
  44. Nutritional supports for the older adult include:
    • Vitamin D and calcium supplementation
    • Congregate meals
    • Meals on wheels
  45. Psychosocial interventions to improve self-concept and alleviate social isolation for the older adult include:
    • Therapeutic communication
    • Touch
    • REality orientation
    • Validation therapy
    • Reminiscence therapy
    • attending to physical appearance
    • Assisitve devices (hearing aids, walkers, etc)
  46. List several factors tht put the older adult at an increased risk for falls
    • Impaired vision
    • Impaired mobility due to arthritis, muscle weakness, and pain
    • Slowed reaction time
    • Bowel or bladder incontinence
    • Side effects of meds
  47. What measures can be implemented in the home to decrease th risk of falls for the older adult?
    • Remove throw rugs
    • Make sure extension and phone cords are out of the walkays/hallays
    • Install bath railings or grab bars
    • Install hand rails atstairways
    • Eliminate clutter
  48. Identify lifestyle recommendations for the older adult client in order to promote health and independence
    • Aerobic and wieght-bearing exercises
    • Maintenance of appropriate body weight
    • Balanced diet with use of supplements as needed
    • Participation in socially satisfying activities
    • Regular physical exam
  49. An older adult client who was treated with bronchitis 2 days ago is receiving home health care. Teh client's daughter tells teh nurse providing the care that her father was find yesterday, bu was up several times during the nightr looking for his son who lives in another state, emptying desk drawers, and then accusing her of stealing. What is the most likely cuase of this cognitive change?
    • B/c of the acute onset, probably delirium.
    • The client also had bronchitis which could have progressed to pneumonia, the infection causing the delirium
  50. Delirium, as oposed to dementia, is typically
    A. Caused by unknown factors
    B. Progressive in nature
    C. Acute
    D. Chronic
    C. Acute
    (this multiple choice question has been scrambled)
  51. Presbyopia is a common visual age-related change that results in a declien in
    A. Far vision
    B. Near vision
    C. Central vision
    D. Peripheral visoin
    B. near vision
    (this multiple choice question has been scrambled)

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